Failure to Include QIO Contact Information on NOMNC Letters
Penalty
Summary
The facility failed to provide required information on the Notice of Medicare Non-Coverage (NOMNC) letters for two residents who were reviewed for beneficiary notices. Specifically, the NOMNC letters for these residents did not include the name or telephone number of the Quality Improvement Organization (QIO), which is necessary for residents or their representatives to appeal the termination of skilled services. This omission was confirmed during interviews with the Chief Clinical Officer, who acknowledged the missing information, and the Business Office Manager, who indicated she received the corrected form from the Administrator after the deficiency was identified. The review of the medical records showed that both residents had been admitted to the facility and had skilled services ending on specific dates, but their NOMNC letters lacked the required QIO contact details.